Provider Demographics
NPI:1053346247
Name:DICKEL, JANE F (LCSW)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:F
Last Name:DICKEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1447 FOURTH ST.
Mailing Address - Street 2:SUITE D
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559-2806
Mailing Address - Country:US
Mailing Address - Phone:707-996-9802
Mailing Address - Fax:707-258-2398
Practice Address - Street 1:1447 FOURTH ST.
Practice Address - Street 2:SUITE D
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-2806
Practice Address - Country:US
Practice Address - Phone:707-996-9802
Practice Address - Fax:707-258-2398
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS43531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ81499ZMedicare UPIN